Working as a Doctor in France: EU, Non-EU and PADHUE Routes 2026

France is one of the largest medical labour markets in Europe and has relied heavily on doctors trained abroad, especially in public hospitals. But the route you take depends almost entirely on where your medical degree comes from. A doctor with a degree from an EU country can often register within months. A doctor with a degree from outside the EU usually faces a competitive written exam, a two-year supervised period and a commission review before full practice.

This guide gives the big picture: the authorities, the recognition routes, the PADHUE procedure, language, specialty training and the most common mistakes.

Key facts

The French healthcare system in brief

France has a universal health insurance system. Care is delivered by public hospitals, private non-profit and for-profit clinics, and doctors in private practice (médecins libéraux). Public hospitals are where most non-EU doctors start, because the PADHUE procedure is built around supervised hospital posts.

Medical training for French students runs in three cycles: basic sciences, a clinical second cycle ending with the national EDN and ECOS, and specialty training as an interne. Understanding this helps you see where foreign doctors fit: non-EU doctors who are already qualified do not go back through the EDN but enter through the EVC procedure.

Who does what

• Ordre des médecins. The departmental council registers doctors and checks morality, independence, competence and fitness to practise. Regional and national councils handle appeals.
• Centre national de gestion (CNG). Runs the EVC, assigns laureates to posts and hosts the national commission that reviews files for full authorisation. It also handles the other ministerial authorisation routes for foreign degrees.
• Ministry of Health. Grants the authorisation to practise to doctors with non-EU degrees.
• Regional health agencies (ARS). Play a role in some regional schemes, including special authorisations in overseas territories.
• Universities. Train French students and, since 2025, enrol EVC laureates during their supervised period.

Route 1: degrees from the EU, EEA or Switzerland

If your medical degree is listed under the EU rules on automatic recognition and comes with the required attestations, you can apply directly to the departmental council of the Ordre where you plan to practise. The council checks your diplomas and conditions and decides on registration. No competitive exam is required.

There are also specific procedures for EU nationals whose qualifications do not fit automatic recognition, and for EU nationals with a non-EU degree already recognised in another member state and at least three years of practice there. These go through the CNG.

Route 2: degrees from outside the EU (PADHUE)

With a degree from outside the EU, the Ordre cannot register you on the basis of your diploma alone. It refers you to the CNG for a ministerial authorisation. For most doctors that means the procédure d'autorisation d'exercice, built on four steps:

1. EVC. Competitive written knowledge tests in your specialty. There is a fixed number of posts, and the jury sets the threshold.
2. Assignment. The CNG assigns laureates to hospital posts by rank.
3. PCC. A two-year full-time supervised period for doctors, in your specialty. Since 2025 you also enrol at the linked university and are followed by the local specialty coordinator.
4. Commission and authorisation. The national commission reviews your file. A favourable opinion leads to full authorisation; an unfavourable one can lead to an extended PCC.

Internal and external routes

Since a 2025 reform the EVC have two routes:

• External route: for doctors not yet working in France. Two written tests, one on fundamental knowledge and one on practical knowledge.
• Internal route: for doctors already working in France, for example with at least two years of full-time-equivalent practice in the last three years, or a provisional authorisation (AEP). One written MCQ test, plus a clinical skills attestation from the department.

The 2026 session

For 2026, registration ran from 17 June to 21 July 2026, and the tests start in November 2026. The assignment of main-list laureates is planned for the first quarter of 2027. The full detail is in our EVC guide for foreign doctors.

Provisional authorisation and the PACT status

Many non-EU doctors already work in French hospitals before passing the EVC. Recent reforms created a provisional authorisation to practise (AEP), granted after a commission review of the file, lasting thirteen months and renewable once. It gives access to the status of praticien associé contractuel temporaire (PACT). Holding an AEP with a PACT contract is one of the ways to qualify for the internal EVC route.

Other routes worth checking

• Gulf agreements. Temporary ministerial authorisations of one year are linked to agreements with Saudi Arabia, the UAE, Bahrain, Oman, Kuwait and Qatar. Useful for doctors from the region considering France.
• Cooperation agreements. A host institution can apply to the CNG at least six months ahead for a temporary authorisation of up to two years.
• Quebec mutual recognition. For certain specialists with Quebec degrees and two years of practice.
• Overseas territories. Until 31 December 2030, regional health agencies can authorise non-EU-trained doctors to work in a named facility in certain overseas territories. This authorisation does not extend to mainland France.
• Teaching and research posts. Junior and senior authorisations exist for doctors coming to train or to hold hospital-university posts.

Most of these are temporary. If your goal is permanent full practice, the EVC route remains the main path for non-EU degrees.

Registering with the Ordre: what to prepare

Whichever route you take, registration ends at the departmental council. The file typically includes:

• a valid identity document;
• copies of your diplomas, with certified translations where needed;
• a criminal record extract and a certificate of professional standing from your country, both dated within three months;
• a sworn statement that no disciplinary proceedings are pending;
• certificates from every previous regulator where you were registered, or a sworn statement if you never were;
• proof of the French language skills needed to practise;
• a detailed, up-to-date CV;
• the council's completed form in duplicate and two ID photos.

Non-EU nationals also need a residence permit that allows them to practise. Employment contracts must be sent to the council within one month of signing.

The council has up to three months from a complete file, which can be extended by two months if an expert assessment is ordered. If you hear nothing by the deadline, the silence counts as a refusal that you can contest before the regional council. Appeals must be filed within 30 days.

Costs

Expect costs for certified translations, document legalisation, EVC registration where applicable, travel and relocation, and annual Ordre membership dues once registered. We do not list amounts here because they vary and are not published in one place; check the current figures with the CNG and the Ordre before you budget.

Timeline

For a non-EU doctor starting from abroad, a realistic plan from first registration to full practice is well over three years once you include the EVC cycle and the two-year PCC.

Language requirements

French is essential. You must prove the French needed to practise when you register with the Ordre, and the EVC are entirely in French: long clinical vignettes, French drug names and French guidelines. Even strong clinicians lose marks by misreading. Build medical French alongside your exam preparation, not after it.

Specialty training and specialty recognition

French students choose their specialty through the national matching after the EDN, ECOS and training record. For non-EU doctors, specialty is decided at the EVC: you register in a specialty, compete for its posts and complete your PCC in that specialty. Your full authorisation is then for that profession and specialty. Choose carefully, comparing your training with the number of posts opened.

Working conditions

Most PADHUE start in public hospitals, often in departments with staffing pressure, under supervision during the PCC. After full authorisation and registration you have the same practice rights as other doctors in your specialty, including hospital careers and private practice. We do not quote salaries because official pay depends on status, grade and seniority and changes regularly.

Preparing for the EVC while working

Many candidates prepare for the EVC while already working, either abroad or in a French hospital on a temporary status. A few habits make the difference:

• Study in short, daily blocks. Thirty to sixty minutes of timed French questions every day beats occasional long sessions.
• Read French guidelines in your specialty. They define the expected answers.
• Practise with a timer. The written tests reward speed as well as accuracy.
• Keep an error log. Note whether each miss came from knowledge, language or misreading.

Common mistakes

• Assuming your degree will be recognised automatically. Only listed EU, EEA and Swiss degrees benefit.
• Treating the EVC as pass/fail. It is a competition with limited posts.
• Starting French too late. Language affects both the exam and registration.
• Missing the short registration window. In 2026 it lasted about five weeks.
• Ignoring the internal route. If you already work in France, you may qualify for a single-test route with many more posts.
• Translating documents with inconsistent names or dates. This delays both the CNG and the Ordre.

Next steps

1. Identify your route: EU recognition, EVC external route or EVC internal route.
2. Order certified translations and certificates of good standing now.
3. Start French-language MCQ practice for the EVC early. The MediFlow Exam Prep app has EVC medicine questions in French with explanations.
4. Read the EVC guide for foreign doctors for the exam itself.
5. If you are a medical student in France, see the EDN guide.